Dr. Rob on the difference between physician have and have-nots:

This does say something about our system; primary care physicians are getting more scarce, people have no money for drugs that they need, primary care physicians cannot buy an EMR for their office as it costs in excess of $50,000 per doctor (often), yet these physicians in Tampa can afford easily that much for an ad in the NY Times e-mail, reaching out to patients all over the country, and even the world.

Despite the opinions of some, we really do have a two-tiered system in this country. There are the haves (the procedure specialists and those who perform cosmetic procedures) whose income is growing, and the have-nots (the thinkers and those who coordinate care for the average person) whose income is dwindling.